Browsing by Author "Birhanu Ribka"

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    Collaboration Between Spiritual (Holy Water) Treatment and Biomedical Treatment at St. Mary Church Outreach Program, Entoto: Pattern of Service Utilization and Attitude of Holy Water Attendants
    (Addis Ababa University, 2014-11) Birhanu Ribka; Baheretibeb Yonas; Asher Laura
    Introduction:The explanation for mental illness in Ethiopia is mainly supernatural That is why the majority of mentally ill people go to spiritual treatments, mainly holy water treatments.The benefits of collaboration between biomedical services and holy water sites are many,including early detection and treatment of mental illness. The St. Mary outreach program aims to help mentally ill people at the St. Mary and St. Michael holy water sites by takingthe bio-medical treatment near them. This is done by volunteer Addis Ababa University(AAU) residents. Methods: This is a mixed quantitative and qualitative study.Study 1: Descriptive evaluation of psychiatric patients that have attended the St. Mary outreach program, Entoto from December of 2011 up to July of 2014. A data extraction form was used to extrat data from patient charts. Data was analyzed using SPSSstatistical software.Study 2: A qualitative study of the holy water attendants ’ attitudes and role was conducted from September to October of 2014. A semi-structured interview was conducted using a topic guide. The interviews were audio recorded, transcribed and coded manually. A thematic analysis was conducted. Result:Study 1: A total of 174 charts were analyzed. The m ean number of patients seen per clinic session have increased by 50 %( 14) in 2005, then by 75 %( 25) in 2006. 79.3% were men, 73.3% had schizophrenia, 89.6% were educated and 61.7% came from Addis Ababa.Study 2: The roles of the holy water attendants include ensuring the hygiene, security and medication adherence of patients . They also act as gatekeepers to the St Mary Clinic.There are two main attitudes towards treatment: both treatments are from God and weshould use both and they contradict because using both is like doubting God. The otherattitude is they complement each other. The attitude of the attendants towardsbiomedical treatment is changing since the training from AAU psychiatrists. Theattendants have their own way of differentiating who should come to the clinic and whoshould not. They bring patients who they consider mentally ill but they don’t bringpeople who have mental illness and spirit possession. Conclusion: The conclusion of the study is that it is possible to collaborate between spiritual treatment and biomedical treatment. Recommendation: To continue having trainings for the attendants and community awareness campaigns focusing on family members of people with mental illness
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    Collaboration Between Spiritual (Holy Water) Treatment and Biomedical Treatment at St. Mary Church Outreach Program, Entoto: Pattern of Service Utilization and Attitude of Holy Water Attendants
    (Addis Ababa University, 2014-11) Birhanu Ribka; Baheretibeb Yonas; Asher Laura
    Introduction:The explanation for mental illness in Ethiopia is mainly supernatural .That is why themajority of mentally ill people go to spiritual treatments, mainly holy water treatments.The benefits of collaboration between biomedical services and holy water sites are many,including early detection and treatment of mental illness. The St. Mary outreach program aims to help mentally ill people at the St. Mary and St. Michael holy water sites by taking the bio-medical treatment near them. This is done by volunteer Addis Ababa University(AAU) residents. Methods: This is a mixed quantitative and qualitative study. Study 1: Descriptive evaluation of psychiatric patients that have attended the St. Maryoutreach program, Entoto from December of 2011 up to July of 2014. A data extraction form was used to extrat data from patient charts. Data was analyzed using SPSS statistical software. Study 2: A qualitative study of the holy water attendants ’ attitudes and role was conducted from September to October of 2014. A semi-structured interview was conducted using a topic guide. The interviews were audio recorded, transcribed and coded manually. A thematic analysis was conducted. Result:Study 1: A total of 174 charts were analyzed. The m ean number of patients seen per clinic session have increased by 50 %( 14) in 2005, then by 75 %( 25) in 2006. 79.3% were men, 73.3% had schizophrenia, 89.6% were educated and 61.7% came from Addis Ababa. Study 2: The roles of the holy water attendants include ensuring the hygiene, securityand medication adherence of patients . They also act as gatekeepers to the St Mary Clinic.There are two main attitudes towards treatment: both treatments are from God and weshould use both and they contradict because using both is like doubting God. The otherattitude is they complement each other. The attitude of the attendants towardsbiomedical treatment is changing since the training from AAU psychiatrists. Theattendants have their own way of differentiating who should come to the clinic and whoshould not. They bring patients who they consider mentally ill but they don’t bringpeople who have mental illness and spirit possession. Conclusion: The conclusion of the study is that it is possible to collaborate betweenspiritual treatment and biomedical treatment. Recommendation: To continue having trainings for the attendants and community awareness campaigns focusing on family members of people with mental illness
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    Descriptive Analysis of Cases Seen at Psychiatric Outpatient Department of Tikur Anbessa Specialized Hospital from Sep 11, 2019 - Mar 9, 2020:A Retrospective Crossectional Study in Addis Ababa, Ethiopia
    (Addis Abeba University, 2020-10) Abebe Tesfanesh; Birhanu Ribka; Bahiretibeb Yonas
    Background :In mental health descriptive studies on the socio-demographic variables provides data regarding study participants and it is necessary for the determination of whether the individuals in a particular study are a representative sample of the target population for the generalizability purpose. It helps to Identify and address differences in care for specific population and for the development of additional patient centered services. Among the study done in Ethiopia, there is an existing inpatient visit study at Amanuel mental specialized hospital. At TASH there is a lackof organized data regarding socio-demographic characteristics, diagnosis, andfrequency of psychiatric illnesses. Objective: To identify the socio-demographic characteristics, diagnosis, and frequency of psychiatric illness at TASH outpatient department of psychiatry. Method : Descriptive study was conducted. The study material was 981 charts of patients,which was assessed from electro-medical recording system, by using a convenient non-probability sampling method to explore the socio-demographics of the patients and their diagnosis. Data was collected by a means of data extraction sheet from electro-medical recording system at TASH. The collected data was analyzed by using SPSS version 25, in the analysis process frequency distribution of variables was calculated. Results :The result of this research has shown that the mean age of patients to care is 30.5,54.5% were male in gender. 18.1 % have a higher-level education, 42.7% are employed, and 43.5% single. 21.9% had a diagnosis of depressive disorder, 20.7 %had schizophrenia spectrum and other psychotic disorder and 17.2 % have neuro developmental disorders. 71.5% are treated with only medication and 23.3% are treated with psychotherapy. Conclusion: The present study point to the need for further research and attention to lack of completeness of the records seen on the socio-demographic and diagnosis variables which could be detrimental to the quality of healthcare service and the need for child and adolescent clinic that is found to hold significantly high number compare to the service provide currently.
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    Descriptive Analysis of Cases Seen at Psychiatric Outpatient Department of Tikur Anbessa Specialized Hospital from Sep 11, 2019 - Mar 9, 2020:A Retrospective Crossectional Study in Addis Ababa, Ethiopia
    (Addis Abeba University, 2020-10) Abebe Tesfanesh; Birhanu Ribka; Bahiretibeb Yonas
    Background In mental health descriptive studies on the socio-demographic variables provides data regarding study participants and it is necessary for the determination of whether the individuals in a particular study are a representative sample of the target population for the generalizability purpose. It helps to Identify and address differences in care for specific population and for the development of additional patient centered services. Among the study done in Ethiopia, there is an existing inpatient visit study at Amanuel mental specialized hospital. At TASH there is a lack of organized data regarding socio-demographic characteristics, diagnosis, and frequency of psychiatric illnesses. Objective : To identify the socio-demographic characteristics, diagnosis, and frequency of psychiatric illness at TASH outpatient department of psychiatry. Method:Descriptive study was conducted. The study material was 981 charts of patients,which was assessed from electro-medical recording system, by using a convenientnon-probability sampling method to explore the socio-demographics of the patientsand their diagnosis. Data was collected by a means of data extraction sheet from electro-medical recording system at TASH. The collected data was analyzed by using SPSS version 25, in the analysis process frequency distribution of variables was calculated. Results The result of this research has shown that the mean age of patients to care is 30.5,54.5% were male in gender. 18.1 % have a higher-level education, 42.7% areemployed, and 43.5% single. 21.9% had a diagnosis of depressive disorder, 20.7 %had schizophrenia spectrum and other psychotic disorder and 17.2 % haveneurodevelopmental disorders. 71.5% are treated with only medication and 23.3%are treated with psychotherapy. Conclusion The present study point to the need for further research and attention to lack of completeness of the records seen on the socio-demographic and diagnosis variableswhich could be detrimental to the quality of healthcare service and the need for childand adolescent clinic that is found to hold significantly high number compare to the service provide currently.
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    Prescription Patterns of Psychotropic Medications for Treatment Naive Patients with Mental Disorder in Amanuel Hospital - a Record-Based Study.
    (Addis Ababa University, 2019-11) Amare Beakal; Fekadu Abebaw; Birhanu Ribka
    Psychotropic medications have been leading treatments for a broad range of mental disorders. But they have also a risk of adverse effects. These adverse effects can potentially decrease drug compliance, predispose to drug induced movement disorders and are associated with an increased risk for several physical diseases. Guideline based prescribing may reduce the risk but there is a gap between guidelines and prescribing practices in commonly prescribed drugs such as antidepressants and antipsychotics. These discrepancies may be associated with lower efficacy (e.g. insufficient dosage or duration) or with increased risk of adverse effects (e.g. hazardous co-prescription). This discrepancy may have the most impact among treatment naive patients. Psychotropic medication experiences for patients at the beginning of treatment may have a lasting impact on their attitudes toward medication and course of illness, this is a critical time to optimize prescribing. There is no adequate information on the patterns of drug prescribing among this population. A study on prescribing practices will help identify opportunities for corrective measures to enhance achievement of therapeutic goals and patients’ quality of life. Study objective:The study aimed to describe the patterns of Psychotropic medications prescription among treatment naive patients with mental illness. The secondary aim was to evaluate concordance with treatment guidelines. Method:A retrospective record review was conducted on 384 treatment naive patients with mental disorder in Amanuel hospital out-patient department (between March 10/2019 and March 29/2019). All records during the study period were evaluated. Results:Records of 384 treatment naive patient’s prescribed with psychotropic medications were evaluated. The overall age of the sample ranged from 15 to 95 years, the mean age was 34.2 years with standard deviation of 16. The prescriptions were ordered to 224 (58.3%) males and 160 (41.7%) females.From these 384 cases patients were prescribed a mean of 2 psychotropic medications. The most common combination psychotropic medications are Antipsychotic with antidepressant, Antipsychotic with benzodiazepine and Two Antipsychotics with Benzodiazepine which are seen in (n=70; (28.6%), (n=51; (20.8%), and, (n=41; (16.7%) respectively.Among the different classes of drugs prescribed, nearly half of psychotropic medication were Antipsychotics (n=317; (49.3%), followed by Antidepressant (n=147; 22.86% (96 TCA, 51 SSRI)), Benzodiazepine (n=118; (18.35%), Anticholinergic agent (n=37; (5.6%), and Anticonvulsant Mood stabilizer (n=24; (3.7%). And of the antipsychotic medications, Risperidone (n=190; (29.5%) (1 mg - 4 mg, mean 2.2 mg) was the most frequent drug under use followed by Haloperidol (n=65; (10.1%) (1.5 mg - 6 mg, mean 2.3 mg). Chlorpromazine, Trifluoperaziane, Olanzapine and Thioridazine were the rest of prescribed antipsychotic drugs. Amitriptyline and imipramine were among tricyclic antidepressants frequently prescribed (n=80; (12.5%) (25 mg - 75 mg, mean 30.6 mg) and (n=16; (2.5%) (25 mg - 50 mg, mean 26.6 mg) times respectively. From SSRI’s Fluoxetine (n=33; (5.1%) (20 mg - 40 mg, mean 21.2 mg) and Sertraline (n=18; (2.8%) (25 mg - 50 mg, mean 48.6 mg) are prescribed. In the present study from Benzodiazepine class Diazepam (n=77; (12%) (5 mg - 20 mg, mean 5.8 mg), Clonazepam (n=29; (4.5%) (0.5 mg - 4 mg, mean 1.5 mg), Lorazepam (n=7; (1.1%) (1 mg - 3 mg, mean 1.9 mg), and Bromazepam (n=5; (0.8%) (Mean 1.5 mg) were the most frequently prescribed medications. From Anticonvulsant Mood stabilizer class Carbamazepine (n=22; (3.4%) (200 mg - 600 mg, mean 363.6 mg) and valproate (n=2; (0.3%) (500 mg - 800 mg, mean 650 mg) were prescribed. Trihexyphenidyl is the only medication from anticholinergics class (n=37; (5.8%) (2 mg - 5 mg, mean 2.9 mg).Out of 140 prescribed parenteral medications assessed Diazepam and Haloperidol were near equally prescribed. The remaining prescribed medication was Fluphenazine Decanoate. Among 270 patients who were seen in 24 hrs or come back for first follow up only (n=5; (0.02%) psychotropic medication associated side effects were recorded.Majority of patients were diagnosed with Schizophrenia Spectrum and Other Psychotic Disorders and was prescribed with (n=122; (62.9%) SGA and (n=63; (32.5%) FGA. Depressive Disorders were the second common diagnosis and was given SGA, TCA, FGA, and SSRIs in (n=40; (47.8%), (n=19; (23.2%), (n=12; (14.6%), (n=10; (1.5%) patients respectively. Bipolar and Related Disorders were prescribed with SGA (n=20; (80%), FGA (n=4; (16%) and Mood stabilizers (n=1; (4%). Conclusion:This is the first study examining psychotropic prescribing patterns in treatment naive mental illness patients in ASMH. In the present study, antipsychotic drugs were the most prescribed psychotropic drug, followed by antidepressant drugs. There is also moderate use of benzodiazepines, mood stabilizers and anticholinergic drugs. Risperidone was the most frequently prescribed drugs from second generation antipsychotics and tricyclic aantidepressants (mainly amitriptyline) remain the most frequently prescribed class of antidepressants. The current study showed a significant psychotropic medication combination is prescribed to treatment naive patients. This study also showed off-label prescription of (n=11; (17.5%) intravenous administration of haloperidol for treatment naive patients and (n=15; (10.7%)patients were prescribed with long acting antipsychotic Fluphenazine Decanoate. Avery low side effects associated with psychotropic medications were recorded among patients who were seen in 24 hrs or come back for first follow up.
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    Prescription Patterns of Psychotropic Medications for Treatment Naive Patients with Mental Disorder in Amanuel Hospital - a Record-Based Study.
    (Addis Ababa University, 2019-11) Amare Beakal; Fekadu, Abe; Birhanu Ribka
    Psychotropic medications have been leading treatments for a broad range of mental disorders. But they have also a risk of adverse effects. These adverse effects can potentially decrease drug compliance, predispose to drug induced movement disorders and are associated with an increased risk for several physical diseases. Guideline based prescribing may reduce the risk but there is a gap between guidelines and prescribing practices in commonly prescribed drugs such as antidepressants and antipsychotics. These discrepancies may be associated with lower efficacy (e.g. insufficient dosage or duration) or with increased risk of adverse effects (e.g. hazardous co-prescription). This discrepancy may have the most impact among treatment naive patients. Psychotropic medication experiences for patients at the beginning of treatment may have a lasting impact on their attitudes toward medication and course of illness, this is a critical time to optimize prescribing. There is no adequate information on the patterns of drug prescribing among this population. A study on prescribing practices will help identify opportunities for corrective measures to enhance achievement of therapeutic goals and patients’ quality of life. Study objective The study aimed to describe the patterns of Psychotropic medications prescription among treatment naive patients with mental illness. The secondary aim was to evaluate concordance with treatment guidelines. Method A retrospective record review was conducted on 384 treatment naive patients with mental disorder in Amanuel hospital out-patient department (between March 10/2019 and March 29/2019). All records during the study period were evaluated. Results Records of 384 treatment naive patient’s prescribed with psychotropic medications were evaluated. The overall age of the sample ranged from 15 to 95 years, the mean age was 34.2 years with standard deviation of 16. The prescriptions were ordered to 224 (58.3%) males and 160 (41.7%) females. From these 384 cases patients were prescribed a mean of 2 psychotropic medications. The most common combination psychotropic medications are Antipsychotic with antidepressant, Antipsychotic with benzodiazepine and Two Antipsychotics with Benzodiazepine which are seen in (n=70; (28.6%), (n=51; (20.8%), and, (n=41; (16.7%) respectively. Among the different classes of drugs prescribed, nearly half of psychotropic medication were Antipsychotics (n=317; (49.3%), followed by Antidepressant (n=147; 22.86% (96 TCA, 51 SSRI)), Benzodiazepine (n=118; (18.35%), Anticholinergic agent (n=37; (5.6%), and Anticonvulsant Mood stabilizer (n=24; (3.7%). And of the antipsychotic medications, Risperidone (n=190; (29.5%) (1 mg - 4 mg, mean 2.2 mg) was the most frequent drug under use followed by Haloperidol (n=65; (10.1%) (1.5 mg - 6 mg, mean 2.3 mg). Chlorpromazine, Trifluoperaziane, Olanzapine and Thioridazine were the rest of prescribed antipsychotic drugs. Amitriptyline and imipramine were among tricyclic antidepressants frequently prescribed (n=80; (12.5%) (25 mg - 75 mg, mean 30.6 mg) and (n=16; (2.5%) (25 mg - 50 mg, mean 26.6 mg) times respectively. From SSRI’s Fluoxetine (n=33; (5.1%) (20 mg - 40 mg, mean 21.2 mg) and Sertraline (n=18; (2.8%) (25 mg - 50 mg, mean 48.6 mg) are prescribed. In the present study from Benzodiazepine class Diazepam (n=77; (12%) (5 mg - 20 mg, mean 5.8 mg), Clonazepam (n=29; (4.5%) (0.5 mg - 4 mg, mean 1.5 mg), Lorazepam (n=7; (1.1%) (1 mg - 3 mg, mean 1.9 mg), and Bromazepam (n=5; (0.8%) (Mean 1.5 mg) were the most frequently prescribed medications. From Anticonvulsant Mood stabilizer class Carbamazepine (n=22; (3.4%) (200 mg - 600 mg, mean 363.6 mg) and valproate (n=2; (0.3%) (500 mg - 800 mg, mean 650 mg) were prescribed. Trihexyphenidyl is the only medication from anticholinergics class (n=37; (5.8%) (2 mg - 5 mg, mean 2.9 mg). Out of 140 prescribed parenteral medications assessed Diazepam and Haloperidol were near equally prescribed. The remaining prescribed medication was Fluphenazine Decanoate. Among 270 patients who were seen in 24 hrs or come back for first follow up only (n=5; (0.02%) psychotropic medication associated side effects were recorded. Majority of patients were diagnosed with Schizophrenia Spectrum and Other Psychotic Disorders and was prescribed with (n=122; (62.9%) SGA and (n=63; (32.5%) FGA. Depressive Disorders were the second common diagnosis and was given SGA, TCA, FGA, and SSRIs in (n=40; (47.8%), (n=19; (23.2%), (n=12; (14.6%), (n=10; (1.5%) patients respectively. Bipolar and Related Disorders were prescribed with SGA (n=20; (80%), FGA (n=4; (16%) and Mood stabilizers (n=1; (4%). Conclusion This is the first study examining psychotropic prescribing patterns in treatment naive mental illness patients in ASMH. In the present study, antipsychotic drugs were the most prescribed psychotropic drug, followed by antidepressant drugs. There is also moderate use of benzodiazepines, mood stabilizers and anticholinergic drugs. Risperidone was the most frequently prescribed drugs from second generation antipsychotics and tricyclic antidepressants (mainly amitriptyline) remain the most frequently prescribed class of antidepressants. The current study showed a significant psychotropic medication combination is prescribed to treatment naive patients. This study also showed off-label prescription of (n=11; (17.5%) intravenous administration of haloperidol for treatment naive patients and (n=15; (10.7%)patients were prescribed with long acting antipsychotic Fluphenazine Decanoate. Avery low side effects associated with psychotropic medications were recorded among patients who were seen in 24 hrs or come back for first follow up.
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    Subjective Experiences of Clients who have Attended Psychotherapy at Tikur Anebessa Specialized Hospital and Zewditu Memorial Hospital, Ethiopia 2021: A Qualitative Study
    (Addis Ababa University, 2021-11) Tumiso Eshetu; Mengesha Filmon; Birhanu Ribka
    Background :Psychotherapy, traditionally known as talk therapy is one of the main management modalities used in mental health. It is used to help clients with claimed psychosocial problems to overcome theirsymptoms and to improve their well being and mental health by applying psychosocial methods. Clients are the reasons why all the psychotherapies are made for and understanding their subjectiveexperiences of the psychotherapies helps us theunderstanding them, to make psychotherapymeaningful and to design contextual modalities of intervention compatible to a given psychosocialcontext. This study focuses on assessing the subjective experiences of clients who have attendedpsychotherapy at TASH and ZMH. Objective :To explore and understand the subjective experiences of clients who have attended psychotherapy at TASH and ZMH, so that we would learn from how psychotherapy appears for the clients from their perspective. Method :Qualitative study was conducted on clients who have attended psychotherapy at TASH and ZMH by using in-depth semi-structured interview questions that was prepared after referring different articles on the topic. Participants were recruited using non-probabilistic heterogeneous purposive sampling technique from the hospitals referred above. Participants were those who have attended psychotherapy at least for four sessions, consented to take part, speak Amharic language fluently and on stable mental condition. Sampling proceeded until theoretical saturation was achieved.Eight in-depth interviews were conducted and all were included in the results. The in-depth interviews were audio recorded, transcribed and translated into English. Thematic analysis was used to identify key themes. Findings The subjective experiences of clients who have attended psychotherapy were summarized in to four majorthemes with subordinate subthemes. Firstly, how clients perceived psychotherapy and all of them havedefined it as a means of discharging out impacted emotions. They have also differentiated talk therapy fromother routine advices based on their experiences and they have had different types of goals set bycollaborating with the clinicians. The second theme was their positive experiences and except one all of the participants had helpful experiences which were categorized under how it has impacted their self concept, their social life and their understanding of factors that had contributed to their illnesses. Clientshave also described mechanisms at which how psychotherapy has healed them. In the healing process is attributed to clinicians’ factors such as empathic listening and clients’ factors such as willingness to behealed and their belief on the therapy. The third theme was the negative experiences of clients. They have experienced it due to different factors like the therapist, the society and the therapy itself. How they had experienced relationships were the fourth theme identified. Conclusion:Clients have experienced psychotherapy as beneficial in most cases and harmful in some cases. What mattered most for the clients were; an empathic listening, unconditional acceptance and their connection with the therapist who is emotional sensitive and focusing on them as a person not on their problems as priority. Therapists’ being not persistent and sensitive had a counterproductive effect on the therapeutic alliance and contributed to the worsening of symptoms. Clients were not comfortable with frequent turnover of clients, being evaluated in front multiple people and long waiting time they spent. Most of the concepts mentioned as healing mechanisms and negative impacts were mainly described in the contexts of identity of clients, interpersonal relationships and social life.
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    Subjective Experiences of Clients who Have Attended Psychotherapy at Tikur Anebessa Specialized Hospital and Zewditu Memorial Hospital, Ethiopia 2021: A Qualitative Study
    (Addis Ababa University, 2021-11) Tumiso Eshetu; Mengesha Filmon; Birhanu Ribka
    Background :Psychotherapy, traditionally known as talk therapy is one of the main management modalities usedin mental health. It is used to help clients with claimed psychosocial problems to overcome theirsymptoms and to improve their well being and mental health by applying psychosocial methods. Clients are the reasons why all the psychotherapies are made for and understanding their subjective experiences of the psychotherapies helps us the understanding them, to make psychotherapymeaningful and to design contextual modalities of intervention compatible to a given psychosocialcontext. This study focuses on assessing the subjective experiences of clients who have attendedpsychotherapy at TASH and ZMH. Objective: To explore and understand the subjective experiences of clients who have attended psychotherapyat TASH and ZMH, so that we would learn from how psychotherapy appears for the clients fromtheir perspective. Method :Qualitative study was conducted on clients who have attended psychotherapy at TASH and ZMHby using in-depth semi-structured interview questions that was prepared after referring differentarticles on the topic. Participants were recruited using non-probabilistic heterogeneous purposive sampling technique from the hospitals referred above. Participants were those who have attendedpsychotherapy at least for four sessions, consented to take part, speak Amharic language fluently and on stable mental condition. Sampling proceeded until theoretical saturation was achieved.Eight in-depth interviews were conducted and all were included in the results. The in-depthinterviews were audio recorded, transcribed and translated into English. Thematic analysis wasused to identify key themes. Findings The subjective experiences of clients who have attended psychotherapy were summarized in to four majorthemes with subordinate subthemes. Firstly, how clients perceived psychotherapy and all of them havedefined it as a means of discharging out impacted emotions. They have also differentiated talk therapy fromother routine advices based on their experiences and they have had different types of goals set bycollaborating with the clinicians. The second theme was their positive experiences and except one all ofthe participants had helpful experiences which were categorized under how it has impacted their selfconcept, their social life and their understanding of factors that had contributed to their illnesses. Clientshave also described mechanisms at which how psychotherapy has healed them. In the healing process isattributed to clinicians’ factors such as empathic listening and clients’ factors such as willingness to behealed and their belief on the therapy. The third theme was the negative experiences of clients. They have experienced it due to different factors like the therapist, the society and the therapy itself. How they had experienced relationships were the fourth theme identified. Conclusion :Clients have experienced psychotherapy as beneficial in most cases and harmful in some cases. What mattered most for the clients were; an empathic listening, unconditional acceptance and their connectionwith the therapist who is emotional sensitive and focusing on them as a person not on their problems as priority. Therapists’ being not persistent and sensitive had a counterproductive effect on the therapeutic alliance and contributed to the worsening of symptoms. Clients were not comfortable with frequent turnoverof clients, being evaluated in front multiple people and long waiting time they spent. Most of the concepts mentioned as healing mechanisms and negative impacts were mainly described in the contexts of identity of clients, interpersonal relationships and social life.